Forum - Questions & Answers

Sep 25th, 2013 - slackcoder 55 

Place of service for interpretation

I am under the impression that the place of service reported for a professional component of a test is where the data was interpreted and the report generated.

For example a gastroenterologist placed a PH electrode during and endoscopy procedure. The gastroenterologist reports the UGI code with the date and outpatient POS. Then days later when the capsule data is read and interpreted at the office, gastroenterologist reports the date and office place of service.

43235 date of service 5/30/2013 place of service Out patient 22

91110-26 date of service 6/11/2013 place of service clinic 11

Is this the correct way to report the place and dates of service for a two step diagnostic test?

I cannot find any referencing documents on the CMS website. I did find a transmittal that addresses other place of services like physician home or hotel but not specifically addressing interpretation in the office on a different date than the outpatient visit.
Thank You
Louise

Sep 25th, 2013 - nmaguire   2,606 

re: Place of service for interpretation

As of July 1, 2010, Medicare contractors will consider, and providers must
remember, that the appropriate DOS for the professional component is the actual
calendar date that the interpretation was performed. For example, if the test or
technical component was performed on April 30th and the interpretation was read
on May 2nd, the actual calendar date or DOS for the performance of the test is
April 30th and the actual calendar date or DOS for the interpretation or read of the
test is May 2nd
https://www.noridianmedicare.com/provider/updates/docs/mm6375_POS_DOS_Diagnostic_Tests.pdf

page 2

Sep 27th, 2013 - slackcoder 55 

re: Place of service for interpretation

Thank you I do understand the date of service to be reported but if the place of service for the interpretation is in the office clinic and the test was performed in the hospital outpatient what POS would the provider report for the interpretation?

Sep 27th, 2013 - nmaguire   2,606 

re: Place of service for interpretation

When the physician’s interpretation of a diagnostic test is billed separately from the
technical component, as identified by modifier -26, the interpreting physician must report the address and ZIP code of the interpreting physician’s location on the claim form



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